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Insights into hypothalamic-pituitary dysfunction in polycystic ovary syndrome
J E Hall1, A E Taylor, F J Hayes
1National Center for Infertility Research and Reproductive Endocrine Unit, Massachusetts General Hospital, Boston 02114, USA.
Journal of Endocrinological Investigation
|December 18, 1998
Summary
Polycystic ovary syndrome (PCOS) is linked to abnormal gonadotropin secretion, specifically an elevated LH/FSH ratio in most patients. This neuroendocrine defect may involve altered GnRH secretion and feedback mechanisms.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Neuroendocrinology
Background:
- Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by menstrual dysfunction and hyperandrogenism.
- The exact pathogenesis of PCOS is complex and involves multiple systems, with a known association with abnormal gonadotropin secretion.
Purpose of the Study:
- To investigate the neuroendocrine mechanisms underlying abnormal gonadotropin secretion in PCOS.
- To identify factors contributing to the elevated LH/FSH ratio observed in women with PCOS.
Main Methods:
- Analysis of gonadotropin secretion patterns in women meeting PCOS criteria.
- Evaluation of potential roles for GnRH secretion frequency, progesterone feedback, estrogen, androgens, and obesity.
Main Results:
- An increased LH/FSH ratio was identified in 94% of women with PCOS.
- Evidence suggests increased GnRH secretion frequency and altered pituitary sensitivity to GnRH contribute to the elevated LH/FSH ratio.
- Obesity was found to have an inhibitory effect on LH secretion.
Conclusions:
- Abnormal gonadotropin secretion, particularly an increased LH/FSH ratio, is a key feature of PCOS.
- Neuroendocrine dysregulation involving GnRH, progesterone feedback, and potentially estrogen, androgens, and obesity plays a significant role in PCOS pathogenesis.